DESCRIPTION (adapted from application abstract): This is a K24 application from Michael Fine, M.D., M.Sc.. Dr. Fine is an Associate Professor in the Division of General Medicine at the University of Pittsburgh. His intermediate career objectives are (1) to further establish himself as a leading national authority on the quality and cost-efficiency of medical care for patients with community-acquired pneumonia (CAP), and (2) to serve as a mentor for medical trainees and junior faculty member pursuing patient- oriented research careers. His long-term objectives are (1) to apply the expertise in quality improvement developed throughout his systematic study of CAP to other clinical research areas of high priority to NIAID, and (2) to actively participate in the institutional commitment to promote patient- oriented research at the University of Pittsburgh. The candidate's patient- oriented research will be conducted in two phases. In phase I (years 1-3), he will direct a randomized clinical trial to assess the effectiveness of two medical practice guideline implementation strategies in improving the quality of medical care for patients with CAP. This trial will be supported by an RO1. In phase II (years 4 and 5), he will expand his research to the quality improvement of other clinical domains of high priority to NIAID. In both phases, medical trainees and junior faculty mentored by the candidate will be integral participants in his research activities. Over the course of the award, the candidate will mentor 5 medical students and residents, 6 clinical research fellows, and 4 junior faculty members in patient-oriented research. The candidate has already identified 2 of the clinical fellows and 1 junior faculty that he will mentor. Research training and education experiences, tailored to the level of the menthe, will include a mentored patient-oriented research project, participation in a weekly journal club, weekly research seminars, and year-round graduate-level coursework.